Provider Demographics
NPI:1558047787
Name:SPIELMAN, ROBERT DAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAN
Last Name:SPIELMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WASHINGTON ST APT 512A
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5349
Mailing Address - Country:US
Mailing Address - Phone:415-690-3630
Mailing Address - Fax:
Practice Address - Street 1:2202 SULLIVAN TRL
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-7901
Practice Address - Country:US
Practice Address - Phone:610-810-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044936122300000X
NJ22DI030665001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentistGroup - Single Specialty